Adult Vaccination: A Performance Improvement Approach
Request for Proposal from the Physicians’ Institute
Introduction: The Partnership for Adult Vaccination and Education (of which the Physicians’ Institute is a
member) received an educational grant from GSK to increase the number of eligible persons who receive all of
the adult vaccines currently recommended by the US Centers for Disease Control and Prevention (CDC) Advisory
Committee on Immunization Practices (ACIP). The healthcare gap involving adult immunizations has led to
thousands of deaths each year from vaccine-preventable illness.
Many factors contribute to the adult immunization gaps, including provider knowledge, competence, and
performance gaps. Studies indicate that most health care providers don’t conduct an evaluation, such as a chart
review, of their adult immunization performance. In addition, more than half of providers indicate that they do
not always inform patients about the consequences of missing vaccinations. Furthermore, studies show that
many healthcare providers are unaware of specific immunization guidelines and schedules.
The purpose of this coordinated educational effort is to ensure that all adults receive each of the vaccines that
are recommended by the ACIP through the following:
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Identify all adult patients whom the ACIP recommends should currently receive an adult immunization.
Offer immunization and appropriately counsel adult patients whom the ACIP currently recommends
should receive an adult vaccine regarding risks and benefits of immunization.
Ensure that adult patients eligible to receive an ACIP-recommended vaccine are actually immunized.
Description of grant opportunity: As part of this national initiative, the Physicians’ Institute’s is managing
twelve performance improvement initiatives targeting primary care physicians and their teams in Georgia,
Florida, Kentucky and Oklahoma (areas with lower immunization rates).
Participating physicians may opt for one of two approaches to complete this performance improvement
activity. Both approaches will earn 20 AMA PRA Category 1 CreditsTM, but only the MOC option offers the
opportunity to earn points towards Maintenance of Certification* (MOC) Part IV from the American Board of
Internal Medicine:
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MOC: Maintenance of Certification Approved Quality Improvement (AQI) Pathway by the American
Board of Internal Medicine (ABIM), offers diplomates the opportunity to earn 20 Maintenance of
Certification (MOC) points. The MOC* option will require participants to conduct chart review (25-50
charts) for each of ten immunization measures in addition to five patient surveys. *Note: MOC Credit
applied for – Determination mid September 2011.
PI-CME: The activity must comply with the three-stage PI -CME model described by the American
Medical Association in the PRA Handbook, offering the opportunity to earn 20 AMA PRA Category 1
Credits™. The PI-CME option only requires participants to conduct chart review (minimum 10 charts)
for two or more selected immunization measures.
In addition to the performance improvement component, this initiative includes online resources, CME activities
and communications training:
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Each applicant organization will identify five or more physicians to participate in the performance
improvement patient chart audit utilized to collect data regarding demographics and vaccinations.
(Detail on the process will be on the website as it becomes available, www.physiciansinstiute.org)
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An online tool will be provided to capture the data from the chart audit to enable aggregate analysis,
provide educational resources and to manage the participants’ MOC and PI-CME activities.
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Each applicant will design and offer one or two CME activities (multiple activities are preferred), utilizing
local speakers, focusing on two topic areas: (1) Vaccine Guidelines and Integration Into Your Practice
and (2) Overcoming Patient Resistance to Vaccines. Applicants will be encouraged to develop
multifaceted CME activities that include adult learning strategies, such as case-based learning.
Educational resources such as videos and support materials will be supplied to the grantees. The
audience for these activities includes but is not limited to the PI CME participants.
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Each selected grantee will be provided with a scholarship for registration fees to send one of their key
providers to a two-day Motivational Interviewing workshop scheduled for October 28-29 in Atlanta. See
http://www.physiciansinstitute.org/meetings/comMIt.php. Grant funds can be utilized to support
travel expenses.
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Project coordinators will provide support for the follow-up evaluation activities and submit a final
report.
If your organization is an accredited CME provider, you are eligible to apply for a grant. Accredited providers
may engage in partnerships, co-sponsorship or joint sponsorship with non-accredited providers.
Grants: Grants will be considered at a maximum of $20,000. You are encouraged to seek additional support,
including in-kind support, from other sources. Projects that demonstrate the most potential for improving
physician practices will receive priority. Grant recipients will be selected by a Physicians’ Institute Review
Committee.
Grant monies can only support focused CME educational activities, educational resources to support those
activities, and follow-up evaluation. Grant funds can also be used to support chart audit expenses for
participating providers (not staff salaries). None of the educational grant monies can be used to pay for
equipment, patient care, medications or to benefit individual physician offices. Physicians cannot be
compensated or provided incentives for attending a CME activity. Grant monies cannot be used to pay
physicians to provide patient care. Examples of appropriate expenditures of grant funds include:
 Associated costs of data collection (chart abstraction, materials, consultants)
 CME activity(s) as a part of the intervention
 Process improvements (including non-educational strategies such as colored files, flags, reminders,
educational aids)
 Food items for team meetings
Resources: The following resources will be available to selected grantees:
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Webinar training will be provided on how to utilize the online performance improvement system.
A variety of resource materials have been developed by the PAVE Partnership and will be available to all
participating organizations and providers. These materials include videos, patient education materials
and other resources
The Physician’s Institute Project Manager will communicate with grantees on a regular basis and will be
your contact for issues relating to your grant
CME activity evaluation services will be available for grantees
Performance Improvement consultation is available to grantees
Requirements:
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Submit an application that includes your organization-specific gap analysis, plan for conducting activity,
evaluation strategy and budget using the attached forms. Submit these applications to
cmeresource@bellsouth.net and acohen@mag.org
Select Participants: Recruit at least five participants for the Performance Improvement activity. You are
also encouraged to identify one participant to attend the Motivational Interviewing Communication
Skills Training in Atlanta on Oct 28-29 (with no registration charge).
Evaluation: Participate in the evaluation and follow-up activities and submit a Final Report, an Abstract,
and a budget reconciliation at the end of the project.
Timeline: Grant applications must be submitted by September 16, 2011. Grant awards will be
announced by the end of September and 75% of the award amount will be sent to grant recipients
immediately. Funded activities can begin as soon as the Letter of Agreement (LOA) is signed. Projects
should be completed within nine months. Final reports must be submitted no later than April 30, 2012.
The remaining 25% of the award will be sent to grant recipients within 30 days of submission and
acceptance of the final report.
The grants will be administered through the Physicians Institute for Excellence in Medicine
(www.physiciansinstitute.org)